Page 326 - Chiral Separation Techniques
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13.1 Introduction 319
Examples 1 Disopyramide anti-arrhythmic S(+)-isomer more strongly protein bound Fluvastatin anti-lipidemic (+)-isomer (3R,5S) more strongly inhibits enzyme CYP 2C9 responsible for metabolism of phenytoin and oral anticoagulants Ibuprofen anti-inflammatory Enantiomeric ratio changes in cirrhosis of the liver Hexobarbitone sedative faster in young (–)-isome
Type of effect Differential protein binding Drug interactions Stereoselective inhibition of metabolism Disease states Age
